Provider Demographics
NPI:1326334442
Name:FINO, MARYBETH (RPH)
Entity Type:Individual
Prefix:
First Name:MARYBETH
Middle Name:
Last Name:FINO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 WILKES BARRE TOWNSHIP CMNS
Mailing Address - Street 2:T-1845
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6846
Mailing Address - Country:US
Mailing Address - Phone:570-829-4983
Mailing Address - Fax:
Practice Address - Street 1:3400 WILKES BARRE TOWNSHIP CMNS
Practice Address - Street 2:T-1845
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6846
Practice Address - Country:US
Practice Address - Phone:570-829-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042072T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist